Provider Demographics
NPI:1346047354
Name:SAAB, JERRY D JR
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:D
Last Name:SAAB
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:RALSTON
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3924
Mailing Address - Country:US
Mailing Address - Phone:402-943-9577
Mailing Address - Fax:
Practice Address - Street 1:7609 OAKWOOD ST
Practice Address - Street 2:
Practice Address - City:RALSTON
Practice Address - State:NE
Practice Address - Zip Code:68127-3924
Practice Address - Country:US
Practice Address - Phone:402-943-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities